Like me, you may have thought it was about better statistics on breast cancer detection and survival. It wasn’t. It was a cost benefit analysis. Stay with me on this, because this article is not about breast cancer or mammograms, but we need to go there to get to the point.
It turns out the U. S. Preventative Services Task Force, which had recommended in 2002 that all women over 40 receive screening mammograms decided last week that only women between 50 and 75 should receive the tests unless there is an underlying history to indicate otherwise. Routine mammograms have reduced the incidence of breast cancer in women by 30%. According to the Wall Street Journal, 40% of patient years saved by mammograms are for women under 50, but it takes 1,904 mammograms to detect one case of cancer for women in their 40s and only 1,339 to detect a case in a woman in her 50s. Of course the number would decrease for a woman over 75, but the task force decided that she was so close to the end of her life that we would be wasting money on her. According to the op-ed article in last Thursday’s Wall Street Journal, the task force has no oncologists or radiologists, but they decided that the cost was too great to have women in their 40s or over 75 undergo the tests.
We should all make medical decisions based on our own cost benefit analysis. There are a whole host of tests and procedures that we don’t do because the cost and inconvenience of going through those tests doesn’t compute for us. But we make those decisions with our own lives and our own money. What we have here is a panel whose decisions are generally accepted by Medicare making that decision.
President Obama and many of his fellow Democrats in congress have been assuring us that there would be no rationing with their version of health-care reform. But there will have to be guidelines adhered to. It may not be unreasonable to weigh the cost of a procedure against its potential benefits, but when we put an impersonal government agency in charge of determining costs, benefits and eligible recipients of care, we are putting our vary lives in the hands of a government that does not know us personally. When that happens, you can count on sacrificial lambs as budget deficits increase and resources become scarcer.
